Observational studyAnesthesia and analgesia2020
Epidural Analgesia During Childbirth and Postpartum Depressive Symptoms: A Population-Based Longitudinal Cohort Study.
Observational study in Anesthesia and analgesia, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 34 citations in OpenAlex.
- The association between labor epidural analgesia and postpartum depression: a systematic review and meta-analysis.BMC women's health · 2020Pooled it
- Beyond pain relief: reframing labor analgesia as part of comprehensive, psychologically informed perinatal care.Journal of anesthesia · 2026Article
- Association between the effectiveness of labor epidural analgesia and postpartum depression: a prospective cohort study.Journal of anesthesia · 2026Observational
- The impact of combined spinal-epidural analgesia (CSEA) on postpartum depression: A Mendelian randomization study.Canadian journal of pain = Revue canadienne de la douleur · 2026Article
- Influence of Neuraxial Anesthesia Technique During Vaginal and Cesarean Delivery and Association with Postpartum Depression: A Narrative Review of Literature.Neuropsychiatric disease and treatment · 2026Review
- The role of anesthesiologists in postpartum depression: current perspectives and future directions.Frontiers in psychiatry · 2025Review
- Hydromorphone ameliorates postoperative pain and depressive disorder in women receiving cesarean section under spinal anesthesia.Frontiers in medicine · 2025Article
- Association between epidural analgesia and postpartum psychiatric disorders: A meta-analysis.Heliyon · 2024Article
- The association between labour epidural analgesia and postpartum depression in primiparous patients: a historical cohort study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2023Article
- Antepartum depressive symptoms are associated with significant postpartum opioid use.American journal of obstetrics & gynecology MFM · 2023Article
- Association between the use of epidural analgesia during labour and incidence of postpartum depression.PloS one · 2023Observational
- Predictors of Postpartum Depression among Italian Women: A Longitudinal Study.International journal of environmental research and public health · 2022Article
- Childbirth Pain, Labor Epidural Analgesia, and Postpartum Depression: Recent Evidence and Future Directions.Journal of pain research · 2022Review
- A Study on the Preventive Effect of Esketamine on Postpartum Depression (PPD) after Cesarean Section.Computational and mathematical methods in medicine · 2022Article
- Perinatal depression.International anesthesiology clinics · 2021Article
- Labor Pain, Analgesia, and Postpartum Depression: Are We Asking the Right Questions?Anesthesia and analgesia · 2020Article
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSevere pain has been linked to depression, which raises the question of whether epidural analgesia (EDA) during childbirth is associated with a reduced risk of postpartum depression (PPD). This association has been explored previously, but the studies were restricted by small sample sizes and the inability to control for relevant confounders. This study aimed to investigate the association between the administration of EDA and the development of PPD after adjusting for sociodemographic, psychosocial, and obstetric variables.
methodsData were retrieved from the Biology, Affect, Stress, Imaging and Cognition (BASIC) project (2009-2017), a population-based longitudinal cohort study of pregnant women conducted at Uppsala University Hospital, Sweden. The outcome was PPD at 6 weeks postpartum, defined as a score of ≥12 points on the Edinburgh Postnatal Depression Scale (EPDS). Information was collected through medical records and self-reported web-based questionnaires during pregnancy and 6 weeks after childbirth. Only primiparous women with spontaneous start of childbirth were included (n = 1503). The association between EDA and PPD was examined in multivariable logistic regression models, adjusting for sociodemographic, psychosocial, and obstetric variables. Results are presented as odds ratios (ORs) with 95% confidence intervals (CIs).
resultsOf the 1503 women included in the analysis, 800 (53%) reported use of EDA during childbirth. PPD at 6 weeks postpartum was present in 193 (13%) women. EDA was not associated with higher odds of PPD at 6 weeks postpartum after adjusting for suspected confounders (age, fear of childbirth, antenatal depressive symptoms; adjusted OR [aOR] = 1.22; 95% CI, 0.87-1.72).
conclusionsEDA was not associated with the risk of PPD at 6 weeks postpartum after adjusting for sociodemographic, psychosocial, and obstetric variables. However, these findings do not preclude a potential association between PPD and childbirth pain or other aspects of EDA that were not assessed in this study.
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